Introduction
Pilonidal sinus excision and reconstruction is a surgical procedure used to treat pilonidal sinus disease. The pilonidal sinus is a small tunnel or cyst that forms in the skin at the top of the buttocks, near the tailbone (coccyx). It can become infected, leading to pain, swelling, and drainage of pus or fluid.
Indications
The surgery is indicated for cases where conservative treatments, such as antibiotics and drainage of the abscess, have failed to resolve the condition or when the pilonidal sinus becomes recurrent.
Preoperative Instructions
Dr Moar will provide preoperative instructions specific to your circumstances, which will generally include fasting, and medication adjustments. You will undergo a health status assessment and we will request your informed consent.
Procedure
The surgery is performed under general anesthesia.
Dr Moar will make an incision to remove the entire pilonidal sinus, including any tracts or extensions. This is done to prevent recurrence. Once the sinus is excised, the wound is reconstructed. There are various techniques for reconstruction, and the choice depends on the size and complexity of the wound. Primary closure or flap procedures are commonly used techniques. Occasionally it may be necessary to leave the wound open for it to heal by secondary intention.
Postoperative Instructions
After the surgery, patients will receive postoperative instructions to promote proper healing and prevent complications. These may include:
- Pain Management: Patients will be prescribed pain medications to manage discomfort during the recovery period.
- Wound Care: Specific wound care instructions will be given to keep the surgical site clean and dry. Often a drain tube will be left in the wound for several days after the surgery. This will require care and monitoring of its daily fluid output.
- Activity Restrictions: You will be advised to avoid strenuous activities and heavy lifting for a certain period to allow the wound to heal properly.
- Follow-up Appointments: Regular follow-up visits will be scheduled to monitor the healing progress and remove any sutures and /or drains.
- Keeping the hair trimmed around the wound.
Risks
As with any surgical procedure, pilonidal sinus excision and reconstruction carries some risks and complications, which may include infection, bleeding, wound healing issues, recurrence of the pilonidal sinus, pain and discomfort, scarring, nerve damage, and adverse reaction to anesthesia.
Treatment Alternatives
Conservative treatments for mild pilonidal sinus are:
- Antibiotics to treat infections and reduce inflammation.
- Incision and drainage to drain pus and fluid from the sinus.
- Laser hair removal may sometimes be recommended to help prevent hair from accumulating in the sinus and exacerbating the condition.